by Jessica Schreifels, The Salt Lake Tribune

This article was produced for ProPublica’s Local Reporting Network in partnership with The Salt Lake Tribune. Sign up for Dispatches to get our stories in your inbox every week.

The patients kept coming to the Utah oral surgeon’s office — one after another, year after year — with dental work that the surgeon said had gone wrong. He later recounted in a letter to state licensors that he had seen dental implants that had been the wrong size, patients with chronic sinus infections and one person whose implant had become lost inside their sinus cavity. These patients, he said, had all been worked on by the same dentist: Dr. Nicholas LaFeber.

The surgeon, a 30-year veteran, wrote the letter in November 2022 after Utah’s licensing division asked for his opinion of work done by LaFeber, whose license was on probation after the agency determined he had provided substandard care to more than a dozen patients. His warning was blunt: He believed LaFeber wouldn’t improve as a dentist and should not be performing dental implant procedures. He had seen LaFeber make the same mistakes in patients for years, he wrote, causing “severe” and sometimes life-changing complications.

“I believe that he is not competent to place implants,” the oral surgeon, Dr. Creed Haymond, concluded. “I give this opinion with soberness and sadness, but I feel I have a duty to aid the board in protecting the public from what appears to be an incompetent practitioner.”

His assessment of LaFeber’s skills in restorative dentistry was also mentioned in a February 2023 order regarding agency action on LaFeber’s license. Haymond did not respond to interview requests.

This was the second letter that Utah’s Division of Professional Licensing had received recommending that LaFeber be stopped or limited from practicing after more than a decade of dentistry in Utah, according to records obtained by The Salt Lake Tribune and ProPublica. The agency licenses Utah dentists and other professionals and investigates allegations of misconduct.

Two years prior, another dentist who had considered buying one of LaFeber’s practices recommended LaFeber’s license be revoked after looking through patient files: “As I started going through charts, as well as seeing the previous work, I began to realize how poor he treated these individuals,” wrote Dr. Brandon McKee. “Patients with failed implants are put on antibiotics and told to wait while the implant is continuing to heal. Some of these are for nine months.”

This letter was discussed in a September 2020 public dentistry board meeting. McKee did not respond to interview requests.

The licensing division’s dentistry board — whose members are mostly dentists and hygienists — recommended to Utah licensing director Mark Steinagel in December 2022 that LaFeber’s license be revoked after reviewing additional evidence suggesting his skills had not improved.

But despite this recommendation and the letters of warning from his colleagues, Steinagel reinstated LaFeber’s license in May 2023 after the dentist completed three years of probation, which included taking remedial classes.

Since LaFeber’s license was reinstated, new patients say they’ve been hurt. The Tribune and ProPublica spoke with two patients who say they saw the dentist within the last year for what they believed would be routine cavity fillings. Instead, they say they left in pain that became prolonged and ultimately required the procedures to be redone by other dentists. Neither knew when they sought dental care that LaFeber had nearly lost his license after regulators determined his work fell below the standard of care.

“I had never had this done before, so I didn’t know what’s normal,” said one patient, Michelle Lipsey. “I was just like, ‘He’s an adult, male dentist. He probably knows what he’s doing.’”

Lipsey filed a complaint against LaFeber with licensors in July detailing her experience, but the agency closed the case a month later and took no disciplinary action.

LaFeber said he would not discuss individual patients because they did not grant him permission to do so. He told The Tribune and ProPublica that he has always tried to keep his patients’ best interests in mind. “I had a few outcomes from dental work that had complications and needed further treatment,” he wrote in an email in response to questions.

“I assume every dentist encounters some percentage of negative patient outcomes and I have no reason to believe that my practice had a higher percentage than others.”

Melanie Hall, a spokesperson for Steinagel and the Division of Professional Licensing, said in response to questions that the division only revokes someone’s license when their conduct has been “especially egregious” because doing so “ends a career.”

The agency’s top priority, she said, is keeping Utahns safe — but she added that it also wants to ensure that licensees have a chance at “professional rehabilitation” and, when appropriate, can continue to work and earn money.

The state has revoked two dental licenses since June 2015, according to a Tribune and ProPublica examination of a decade’s worth of publicly available licensing division records.

Hall said that LaFeber’s license was reinstated despite the dental board’s recommendation because the dentist had finished the remedial courses that the board required him to take and his probationary period was ending. She noted that no other patients filed a complaint........

© ProPublica